3 PROPERTY INFORMATION/SERVICE ADDRESS

REGISTRATION FOR WATER & WASTEWATER BILLING

Please use this form for newly purchased property or mailing address updates and submit it to: DEP-BCS, Attn: Registration Unit, 59-17 Junction Blvd, 7th Floor, Flushing, NY 11373

Service Requested (check all that apply):

New Owners (see the back page for more information)

Add Another Name to the Bill

Spelling Correction

Update Mailing Address

Duplicate Bill Copy

Add or Remove Agent/Managing Company

PROPERTY INFORMATION/SERVICE ADDRESS:

New Owners: Do you own other properties? Yes No

ACCOUNT NUMBER:

-

-

Borough:

Property Address:

Block:

Lot:

CITY:

STATE: NEW YORK ZIP:

Purchase Date:

OWNER'S CONTACT INFORMATION:

OWNER'S NAME:

First

Last

Additional Owner's Name (First, Last):

DOB: (MM/YYYY): _ _ / _ _ _ _

Mailing Address: Telephone:

CITY: Email:

STATE:

ZIP:

AUTHORIZE DUPLICATE BILL COPY TO ANOTHER PERSON OR BUSINESS:

Name/Business Name:

Email:

Address:

CITY:

STATE:

ZIP:

MANAGING AGENT/COMPANY INFORMATION:

Name/Business Name:

Email:

Address:

CITY:

STATE:

ZIP:

ONLINE ACCESS:

If you have an existing "My DEP Account" online profile, include your login email:

To delegate access to a managing agent or another person, include their existing online profile email:

VOLUNTARY VETERAN INDICATOR QUESTIONS:

1. Has anyone in your household ever served, or are they currently serving?

Yes

2. Please indicate: U.S. Armed Forces

National Guard

Reserves

3. Please select who served / is serving: Self

Spouse/Partner

Child

No Other (write in) Other (write in)

ACKNOWLEDGEMENT:

I affirm that I am the owner of the above property and understand that the DEP will deliver water and wastewater bills and other communications to the Service (Property) Address shown above and duplicate bills to the Name and Mailing Address shown above. I acknowledge that charges issued against the property must be paid in full by the due date listed or interest charges will be imposed.

Signature of Owner/Authorized Representative Print Name of Person Signing on behalf of the Owner, if applicable:

Date

IMPORTANT INFORMATION FOR PROPERTY OWNERS HOW TO COMPLETE YOUR REGISTRATION FORM

Checking the "New Owners" checkbox on the front of this form or updating the name on the deed will result in CANCELLATION of any existing Service Line Protection Program, Autopay, Payment Plans, Exemptions, Bankruptcy files, and Water Debt Assistance Program (WDAP).

Ownership & Mailing: The recorded deed name must be the primary name on the account. Property owners are responsible for ensuring that bills issued for water and wastewater services delivered and used at the property are paid in full by the due date listed on the bill. Charges for water and wastewater services are considered a true lien against the property until paid in full.

The property owner can choose to have the bill delivered to another address by filling out the mailing address under "Owner's Contact Information" section on the front of this form. The owner can also choose to send a duplicate copy of the bill to another name and address by filling out the "Authorize Duplicate Bill Copy to Another Person or Business" section on the front of this form.

General Information: To learn more about DEP or if you have questions about your bill, visit DEP or call our Customer Service Call Center by phone at the number below. Language services are available. Our website has information about conservation, water saving appliances and other tips to assist you with managing consumption and/or leaks in your property. Your property should be equipped with an AMR (Automated Meter Reading) device. If it is not, please contact the DEP.

Online Access: When the owner receives the first bill, they can register their account online using My DEP Account using the token on the bill. For more information visit DEP. Users can sign up for automatic payments, monthly billing and e-billing. Owners can update their mailing/contact information which will reflect on all accounts under that name. Owners can also delegate access to their online account by sending an invitation online or filling out the "Delegate Information" section on the front of this form. You can view bills, water usage and submit requests like disputes etc. For help with your My DEP Account access issues, please email us at mydephelp@dep..

Veteran Data: The property owner can use this form to provide voluntary veteran information. Please note that this does not affect your bill in any way.

Payments: You can make payments online at dep, over the phone by calling 866-622-8292, or in person at any of our borough offices listed below.

Payments can be mailed to: NYC Water Board P.O. Box 11863 Newark, NJ 07101-8163

If you are behind on your payments, DEP can set up a payment agreement for you. For information about payment agreements, please call (718) 595-7890, Monday to Friday from 9:00am to 5:00pm.

To inquire about DEP services or seek assistance: ? Contact our Customer Service Call Center at (718) 595-7000, Monday, 8:00am to 7:00pm; Tuesday to Friday, 8:00am to

6:00pm; Saturday, 9:00am to 12:00pm. ? Email DEP at: customerservice@dep.. Please include your property address, water and wastewater account number (if

available) and contact information.

Office Locations:

Manhattan: 55 West 125th Street 9th floor

New York, NY 10027

Bronx: 1932 Arthur Ave. 6th floor

Bronx, NY 10457

Brooklyn: 250 Livingston St. 8th floor

Brooklyn, NY 11201

Queens: 96-05 Horace Harding Expy 1st fl

Flushing, NY 11368

Staten Island: 60 Bay Street 6th floor

S.I., NY 10301

Central Office: 59-17 Junction Blvd. Flushing, NY 11373

CRF: 06/2023

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